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FAQ Topic: How We Work

How do you determine the $586 USD cost for fistula repair surgery?

Fistula Foundation arrives at an average cost for one surgery based on aggregate data from impact and financial reports received from partners we fund across Africa and Asia. Actual surgical costs vary depending on the local economies where our partners work. Costs for more complicated surgeries, such as treating dual vaginal and rectal fistula, can be greater. Learn more about the cost of care on Our Strategy page

Does Fistula Foundation provide funding for the Hamlin Fistula Hospitals in Ethiopia?

Fistula Foundation began as a fundraising organization for Hamlin Hospitals and is honored to have provided over $10 million USD in support of Hamlin. Today Fistula Foundation no longer solicits earmarked funds for Hamlin Hospitals, which now runs its own fundraising operations in the U.S., Hamlin Fistula USA. Hamlin Hospitals also has partner organizations in Australia, the UK, the Netherlands, Germany, Sweden, New Zealand and Japan.

What gets funded first? More “traditional” projects, or cutting-edge ideas?

While the bulk of our funding is to pay for fistula surgeries, facilities and equipment, and training for doctors to perform fistula surgeries, we are funding an increasing number of cutting-edge projects.

We think entrepreneurial solutions are a good thing. When our grantees approach us with creative solutions, we listen. For example, in 2010 our grantee Women and Health Alliance International (WAHA) proposed a truly unique intervention solution to us. It was such a good idea, we offered to fund it. WAHA has designed a one-of-a-kind, three-wheeled All Terrain Ambulance Vehicle equipped to transport patients where no paved roads exist. If an emergency arises, this unique All Terrain Ambulance Vehicle can be called by radio to rapidly deliver one patient to the nearest health centre or hospital. The first was delivered in 2010 to Senegal’s Kedougou region. Hundreds more have since been commissioned and distributed throughout Africa since.

How do you find out about new funding opportunities?

We fund projects on an invitation-only basis, and we’re constantly on the lookout. We are in frequent conversation with our international network of surgeons and partner organizations.

How long does it take for a partner to receive funding?

We work fast, because it helps our partners more if they receive their funding quickly. Following a few protocol procedures including Board approval and the signing of a grant agreement, we usually are able to turn around and dispense funds in a few days time if needed.

The good news is that we continue to grow stronger each year. This means that if dedicated surgeons in developing countries come to us for help, we can respond immediately. For example, when Dr. Denis Mukwege, founder of the Panzi Hospital, desperately needed funds after a major donor pulled out, we could respond in a heartbeat. Panzi Hospital remains the leading treatment center for victims of sexual violence in the Congo, including surgery treatment of fistulas.

How does Fistula Foundation make sure my donation is used as intended?

We are committed to getting as much money as possible to our trusted partners in the field, because that’s where women’s lives are changed. 

To ensure funding goes to the most respected local doctors and hospitals in Africa and Asia, Fistula Foundation issues grants on an invitation-only basis. Learn about  our partner selection process

Surgeons and hospitals that receive funding from Fistula Foundation are required to provide quarterly progress reports detailing their project activities and costs, surgical outcomes, and any challenges encountered. Fistula Foundation only releases funds once a partner’s report has been reviewed by our Medical Advisor and Program Development staff.

What type of projects does Fistula Foundation fund?

Wherever possible, we work to empower dedicated local doctors in developing countries. In addition to paying for the direct cost of surgeries, we fund activities that remove critical bottlenecks to treatment. These include the training of surgeons, the building of hospitals and operating rooms dedicated to fistula surgery, community outreach to let women know where they can get treated, and “mobile” fistula clinics to provide treatment in rural areas where no hospitals exist.

We also fund solutions targeted to the specific needs of a partner. For example, in Senegal, we funded a fleet of motorcycle ambulances to transport patients to care facilities over difficult terrain, while in Uganda, we funded the construction of a water tank to secure a source of clean water for surgery and recovery.

Learn more about our Investment Areas

How does Fistula Foundation choose its partners?

We do our homework upfront and only invite funding requests from the very best hospitals and doctors, some of whom operate in the world’s toughest neighborhoods. We never lose sight of the fact that we’re not buying widgets—we’re selecting surgeons to perform intricate, vaginal surgery on horribly injured women.  Cost is not the key variable; the quality and training of the medical team is.  

We vet potential partners through a careful process that draws on the expertise of the Foundation’s Program Development team, Board of Directors, and Grants Review Committee. We also rely on our relationships with Direct Relief and an international network of fistula surgeons who help advise on the reputations of local doctors and the needs that exist in different regions.

Why we don’t focus on prevention?

There were a number of worthy approaches we could have pursued in the fight against fistula, including midwifery training, contraceptive provision, and eliminating child marriage. But one path—providing curative fistula surgery—stood out from these approaches with two clear advantages: 

  • the unmet need to treat women already  injured with fistula is profound
  • the marginal difference surgery can provide is truly life-changing.

This enormous return on investment is precisely why Fistula Foundation focuses solely on delivering fistula repair surgery. With each surgery we provide, we know that we’re helping change one woman’s world forever. And we know that the ripple effect of her restored health—on both her family and community—is profound. Learn more about Our Strategy

How did Fistula Foundation start?

Fistula Foundation was founded in 2000 as an all volunteer organization to support the pioneering Addis Ababa Fistula Hospital in Ethiopia.

Our success between 2004 and 2008 enabled us to dramatically expand our mission in 2009  to fight fistula globally. As a result of this rapid expansion, we have now supported fistula treatment in 32 countries at sites on two continents, Africa and Asia. We fund more obstetric fistula surgeries globally than any other organization.

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